Falcó V, Fernández de Sevilla T, Alegre J, Ferrer A, Martínez Vázquez J M
Department of Internal Medicine, Hospital General Vall d'Hebron, Universidad Autónoma, Barcelona, Spain.
Chest. 1991 Oct;100(4):1007-11. doi: 10.1378/chest.100.4.1007.
In a prospective study of community-acquired pneumonias, 30 patients were diagnosed with Legionnaires' disease in 15 months. Clinical, laboratory and radiologic features of these patients are reviewed and compared with those who have pneumococcal pneumonia. Alcoholism, history of smoking, previous antimicrobial therapy, gastrointestinal and neurologic manifestations, elevations of serum transaminases, alkaline phosphatase and creatinine levels were more frequent in pneumonia due to Legionella pneumophila than in pneumococcal pneumonia. The presence of respiratory failure and radiologic progression were common findings that suggested L pneumophila as the etiologic agent of a community-acquired pneumonia. Development of respiratory failure was associated with involvement of several lobes and isolation of L pneumophila in any specimen. In 21 of 30 patients with Legionnaires' disease, L pneumophila was isolated from respiratory specimens. Overall mortality was 10 percent, but it increased to 27 percent in patients not treated with erythromycin initially.
在一项关于社区获得性肺炎的前瞻性研究中，15个月内有30例患者被诊断为军团菌病。对这些患者的临床、实验室和放射学特征进行了回顾，并与肺炎球菌肺炎患者的特征进行了比较。与肺炎球菌肺炎相比，嗜酒、吸烟史、既往抗菌治疗史、胃肠道和神经系统表现、血清转氨酶、碱性磷酸酶和肌酐水平升高在嗜肺军团菌所致肺炎中更为常见。呼吸衰竭和放射学进展的存在是提示嗜肺军团菌为社区获得性肺炎病原体的常见表现。呼吸衰竭的发生与多个肺叶受累以及在任何标本中分离出嗜肺军团菌有关。在30例军团菌病患者中，有21例从呼吸道标本中分离出嗜肺军团菌。总体死亡率为10%，但在最初未接受红霉素治疗的患者中，死亡率增至27%。
